Mark Faber, M.D., Upper Montclair
Ask Psych MD, Pediatric/Adult Psychiatry
ADHD Part 2
I’ve heard ADHD medicine causes addiction when kids grow up. Is this true?
I’m worried that medicine for ADHD will harm my child’s brain. Does it?
Do children still take Ritalin in school and are they called to the nurse’s office for this?
Does the medicine usually work?
Are there side effects to stimulant medication?
I’ve heard that there are non-stimulant medications available. Do they help also?
Is any medical testing required before starting ADHD medication?
No. Actually, it’s just the opposite. Studies show that teens and young adults treated for ADHD are less likely to be impulsive and abuse substances.
No. The NIH (National Institute of Health) brain imaging data indicate that children treated for ADHD appear to demonstrate a sickening of their cerebral cortex, in line with the brains of children without ADHD. This cortex development may be called “neurogenesis.”
Not usually. Long acting, once daily, stimulant medication is available. Options may include Focalin XR (8 hours), Concerta (12 hours), Vyvanse (12 hours), or Adderall XR (12 hours). These medications are approved for use in for children age six and above.
Yes. Seven in ten children with ADHD do respond to medication treatment options if the medicine is one of those noted above (Question #3). In addition, non-medical strategies may also be of assistance for children who have associated difficulty including mood, anxiety, or behavioral concerns. Such strategies include social skills, behavior plans, individual and family support, as well as collaboration with the school.
Yes. Headache and stomach upset are very common the first week of treatment. Decreased appetite, slowing of growth, and difficulty falling asleep may also occur. Careful monitoring by the treating doctor and family is important and may serve to minimize side effects. Stimulant medication may also increase tics (involuntary motor movements of the face or body). Sometimes stimulant medication may increase obsessive compulsive behavior.
Yes. But they may take longer to work and not be as effective as stimulant ADHD medications. These include Intuniv and Strattera. Intuniv is very helpful in treating impulsivity and hyperactivity. It may also assist with inattention. Intuniv may cause sleepiness and lowering of blood pressure. Strattera may also be helpful for ADHD symptoms but tends to cause fatigue and stomach upset. These medications are often considered if the child has side effects to stimulant medication or significant tics.
Testing may be recommended but is not usually required. For example, a baseline EKG before starting medication and a careful medical history may assure the safe use of medicine. Lab work may also be requested when using Strattera as it is broken down by the liver.